Repair has become an alternative to replacement for bicuspid aortic valves that require surgery for regurgitation with left ventricular volume overload or aortic aneurysm. Over the past 15 years, improvements have been made regarding assessment of valve configuration and annular stabilization. Even though 20-year stability has been achieved in a relevant proportion of repaired bicuspid aortic valves, the new aspects have markedly improved short- to mid-term results and can be expected to lead to true long-term repair stability. In the presence of preserved root dimensions, isolated cusp repair techniques for correction of prolapse are sufficient. Circumferential annuloplasty has become an important part of the procedure. In the presence of root dilatation, root replacement not only eliminates the root pathology but also contributes to valve stability. Almost always cusp repair is also required.